Predictors of Pegylated Interferon Alpha and Ribavirin Efficacy and Long-Term Assessment of Relapse in Patients With Chronic Hepatitis C: A One-Center Experience From China

Abstract

Background:Sustained virological response (SVR) and virological relapse maintain pivotal roles in the management of chronic hepatitis C (CHC); however, there is little data regarding the long-term outcomes of patients with CHC in China.Objectives:We aimed to investigate the predictive factors of therapeutic effect and viral relapse in patients who achieved end-of-treatment response (ETR).Patients and Methods:We retrospectively analyzed clinical, biochemical and virological data of 169 adult patients with CHC from China who were not treated with pegylated interferon-alpha (PEG IFN-α) and ribavirin, of which 142 achieved ETR and with a follow-up period ranging from six months to six years. Statistical analysis was performed by SPSS 20.0.Results:Of the 169 patients, 124 (73.4%) achieved SVR and 23 (16.2%) experienced relapses post-therapy in cases of ETR patients. We considered sex, age, alanine aminotransferase, aspartate transaminase, baseline hepatitis C virus RNA level, HCV genotypes, IL28B rs12979860 genotype, rapid virological response (RVR), and early virological response (EVR). For antiviral effect in patients with CHC, HCV genotypes (2, 3) (χ2 = 11.285, P = 0.001), IL28B genotype (rs12979860 CC) (χ2 = 16.552, P < 0.001), RVR (χ2 = 37.339, P < 0.001), and EVR (χ2 = 70.265, P < 0.001) were significantly correlated with achieving SVR. For ETR patients with long-term follow-up, the relapse rate within six months was significantly higher than within other periods during six-year follow-up (χ2 = 7.792, P = 0.005). Relapse was virtually not observed after therapy ceased for 48 weeks. The IL28B genotype (rs12979860 CT/TT) (OR = 0.102; 95% CI, 0.031-0.339; P < 0.001), lower RVR (OR = 0.239; 95% CI, 0.078-0.738; P = 0.013), and EVR (OR = 0.102; 95% CI, 0.016-0.661; P = 0.017) were independent risk factors for relapse.Conclusions:Our study comprehensively explored the predictive factors of therapeutic effect of administered drugs and analyzed viral relapse during a six-months to six-year follow-up period from China. The SVR may not be the perfect endpoint of HCV therapy in Chinese people; we recommend 48 weeks after treatment withdrawal as the suitable time point.

Interferon Lambda 4 Polymorphism Predicts Sustained Viral Response in Hepatitis C Virus Patients Irrespective of Hepatitis C Virus Genotypes, Ethnicity or Treatment Regimen: Results From a Meta-Analysis

“…Since host genetic polymorphisms near the interferon-λ-3 (IFNL3, formerly known as IL28B) gene was recognized to be strongly associated with response to PEG-IFN/RBV therapy for chronic HCV, several clinical trials have revealed a prediction of treatment outcome by genotyping for the IL28B SNP ( 30 - 32 ). One of our previous studies also found that rates of SVR was significantly higher, and nonresponse and relapse rates were significantly lower in patients, who carried the favorable IFNL3 genotype (C/C for rs12979860) compared to the adverse IFNL3 genotypes (C/T and T/T) ( 33 ). However, the exact mechanisms behind this association were still only partially understood, and GWAS of IFNL3 SNPs were not reported to be functional.…”

Hepatitis C virus genotype 3a: Predictive factors associated with treatment response in patients of Peshawar.

“…EVR defined as undetectable viral RNA 12 weeks after treatment has been described as a strong predictor of achieving SVR [27][28][29] in patients infected with HCV genotype 3a. 30 Monitoring ontreatment viral response has been shown useful in individualizing therapy with a high chance to cure and to prevent therapy from being unnecessarily prolonged. 31 Most of the studies reporting EVR as a predictor of SVR have been done in western countries with focus on genotype 1 infections.…”

Factors That Influence the Virological Response in Patients with Chronic Hepatitis C Treated with Pegylated Interferon and Ribavirin

“…Our study showed that several factors influence the achievement of sustained virological response, such as: age, mode of virus transmission, genotype, severity of inflammatory changes in the liver, BMI and evidence of glucose abnormalities, actually insulin resistance. There are a number of studies that have made the analysis of a factors associated with SVR, highlighting the predictors of sustained virological response [16,17].…”